Clear Aligners: Straightening Teeth Discreetly
Clear aligners for adults: how they work, wear time, suitability, evidence, risks, cost and timing. Aligners are removable and, at Deepcar Dental Care, worn 22 hours a day, so wearing them is your part of treatment. In one study of 2,644 adults treated by one aligner company, 36% were classed as fully compliant, meaning consistent app self-reporting and at least 22 hours’ daily wear, and 38.3% fairly compliant.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Dr Ibraheem Ijaz, principal dentist at Deepcar Dental Care, reviewed this page. He is a General Dental Practitioner with a BDS, a BSc (Hons), an MSc from Leeds, a PG Dip in Implant Dentistry and a PG Cert in Restorative and Aesthetic Dentistry.
What are clear aligners?
Clear aligners are thin, clear, flexible plastic trays that fit closely over the teeth and straighten them gradually, the British Orthodontic Society (BOS) explains. Each aligner in a series moves the teeth a small distance towards the intended position before the next one takes over. They are sometimes called invisible braces or teeth aligners, and BOS describes them as clear, removable, mouthguard-style braces.
BOS says aligners need to be worn full time, day and night except for meal times. At Deepcar Dental Care, clear aligners are worn 22 hours a day.
BOS describes aligners as ideally suited to adults whose lifestyle or work commitments make it difficult to wear more visible fixed braces. Clear aligners are one form of orthodontic treatment. Our guide to clear aligner treatment goes into more depth, and what clear aligners are made from is explained on its own page.
How does clear aligner treatment work?
Clear aligner treatment works through a series of aligners made to a digital plan, each moving the teeth a step further. As general guidance, treatment starts with a digital scan of the teeth, from which a 3D treatment plan is made. You see a simulation of the planned movement, and the aligners are then made to the plan. Your consultation confirms how your own plan is made.
The system used at the practice is Smartee clear aligners. You move to a new aligner every 2 weeks, and how often your progress is reviewed depends on your case.
The scan, attachments, interproximal reduction (IPR), refinements and wear time each have their own page; browse this section to find them.
Why does wear time matter in clear aligner treatment?
Wear time matters because clear aligners are removable, so wearing them full time, as BOS advises, is up to the person having treatment. Two studies give a picture of real-world wear, one from app self-reports and one from sensors built into the aligners.
In a 2021 study of 2,644 adults treated by one aligner company in Germany, 36% were classed as fully compliant, based on consistent use of a self-report app and a wear time of at least 22 hours a day. A further 38.3% were fairly compliant and 25.7% poorly compliant. People who had not had orthodontic treatment before were more compliant than those who had.
A 2026 randomised trial of 43 adults measured wear time with sensors built into their aligners. Wear time fell at later visits. Patients told that the sensors tracked their wear wore their aligners for 4.41 hours a day longer on average than patients told only that the sensors recorded mouth temperature.
Daily life with aligners has its own section, and what does this section cover? has a short answer: one page each on topics including cleaning, eating and drinking, speech, discomfort and lost aligners.
Who is suitable for clear aligners?
Clear aligners are for mild to moderate orthodontic problems, BOS says, after a comprehensive assessment and a discussion of all the available options. It calls them a relatively new way of correcting these problems, most often used where no teeth need removing, and lists these as routine aligner treatments:
- mild to moderate irregularity of the teeth
- crowding that can be corrected with mild to moderate widening of the dental arch
- crowding that can be corrected by reducing tooth width (interproximal reduction, or slenderising)
- mild spacing
BOS gives severe crowding, treatments that need extractions, complex tooth movements and problems that reflect an underlying mismatch in the size or position of the jaws as examples where aligner treatment may need additional techniques, such as fixed braces, to achieve an ideal result.
Severe crowding, bite problems, gum health and existing crowns, veneers or implants each have a page among the options in this section.
At Deepcar Dental Care, clear aligner treatment is for adults only. The problems treated include mild to moderate crowding and spacing, and bite correction. Complex and extraction cases are assessed case by case; some need braces or a combined approach.
How well do clear aligners work?
Evidence on how efficiently clear aligners achieve specific tooth movements is of low to moderate certainty, a 2020 systematic review of seven studies found. For mild to moderate problems, it found aligners may give clinically acceptable results in tilting the upper and lower front teeth, possibly comparable to fixed braces. It also concluded that most tooth movements may not be predictable enough to be achieved with only one set of trays, and that not every clinical situation had been studied.
A second 2020 review included 11 studies of 887 patients, average age 28, comparing aligners with fixed braces for comprehensive treatment. From three studies for each outcome, it found moderate-quality evidence that aligners were linked to a worse score on a standard grading of the finished bite and to more patients with unacceptable results. It found no significant difference in treatment time. The main limitations of the evidence were risk of bias, inconsistency and imprecision. The authors concluded that aligners are associated with a worse treatment outcome than fixed braces in adults, and that current evidence does not support them as equally effective.
To ask about clear aligner treatment, book online or call 0114 288 2121.
What are the risks of clear aligner treatment?
Risks reported with clear aligner treatment include a small loss of root length and, where interproximal reduction is used, harm from removing too much enamel.
A 2024 review of nine studies using 3D CBCT scans found root length was significantly shorter after clear aligner treatment than before, by 0.56 mm on average. It concluded that current evidence suggests clear aligners can cause minimal root resorption, with the most seen in the upper central incisors.
Interproximal reduction (IPR) removes up to 0.5 mm of enamel from the sides of teeth to create space for alignment, BOS explains. It calls IPR a routine procedure that requires care, skill and experience, warns that removing too much enamel can harm the health of the teeth, and says patients should fully understand what is involved before agreeing to it.
A 2014 review found no difference in decay between IPR-treated and untreated tooth surfaces 1 to 7 years later, though its enamel roughness results were too varied for reliable conclusions. A 2022 review of eight clinical studies found no enamel demineralisation, increase in decay, gum changes or sensitivity after IPR, but rated the evidence low to very low quality and called for longer, higher-quality trials.
What does clear aligner treatment at the practice include?
Clear aligner treatment at Deepcar Dental Care is a package that includes:
- a consultation
- a scan and digital plan
- all aligners
- attachments
- IPR where needed
- reviews
- refinements, if your teeth need fine-tuning
- whitening at the end
- retainers
- bonding at the end
How long does clear aligner treatment take?
Clear aligner treatment length depends on how far the teeth need to move, as general guidance. Small front-tooth corrections can take a matter of months, and fuller treatment often takes 12 months or more. Your consultation confirms the expected length for your teeth.
Tooth movement is gradual, and why it takes months is explained on our page about how teeth move.
How much do clear aligners cost?
The practice’s current fee list, which gives “from” prices, shows this price:
- Clear aligners: from £1,495 per arch
Our page about what it costs explains clear aligner costs further.
What happens after clear aligner treatment?
Retainers follow clear aligner treatment. BOS says retainers are needed after any aligner treatment so that the teeth keep their corrected positions. Retainer types, wear and care are covered on our page about the orthodontic retainer.
Whitening and composite bonding after aligner treatment are explained on our page about finishing your result after treatment.
Frequently asked questions
Can you eat and drink with clear aligners in?
Only water, as general guidance. Aligners come out for eating and for drinking anything other than water, then go back in. When they are out, rinse them in cool or lukewarm water, never hot, and brush them gently. Your plan confirms the routine for your own aligners.
What should you do if you lose or break an aligner?
Contact the practice. As general guidance, you may be asked to go back to your previous aligner in the meantime, and your plan confirms what happens next. General aligner care advice is to keep aligners in their case whenever they are out of your mouth.
What are aligner attachments for?
Attachments help aligners grip the teeth and move them. A 2023 systematic review of 26 studies concluded that the use of attachments significantly improves the expression of orthodontic tooth movement and how well aligners stay in place. Your treatment plan confirms how attachments are used for your teeth.
How many aligners will you need?
There is no set number of aligners. Your treatment plan sets the count, and because you move to a new aligner every 2 weeks at the practice, the number of aligners and the length of treatment go together. As general guidance, your 3D plan shows the planned length before you commit.
Why does an assessment matter before aligner treatment?
BOS says that, as with any form of orthodontics, a proper orthodontic assessment, diagnosis and treatment plan is essential to successful aligner treatment. In its statement on interproximal reduction, BOS also notes a rise in online DIY orthodontic systems and recommends that anyone considering orthodontic treatment should avoid DIY braces.
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Deepcar Dental Care is at 334 Manchester Road, Deepcar, Sheffield, S36 2RH. There is free parking directly outside, and the practice is on the ground floor and wheelchair accessible.
By car it is about 15 minutes from Sheffield city centre and about 25 minutes from Barnsley and Rotherham, and getting here for aligner appointments is covered on our local clear aligner page.
You can book online, or call 8am to 8pm, Monday to Sunday. You can read what patients say about their care in our patient reviews.
334 Manchester Road
Deepcar, Sheffield S36 2RH
0114 288 2121
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